# CHUBE2 PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chube2 Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174030605
- **Authorized official:** CRYSTAL HUNT (BILLING MANAGER)
- **Authorized official phone:** (219) 201-8178

## Contact information

- **Practice address:** 600 GRANT ST, GARY, IN 46402-6001
- **Practice address phone:** (219) 201-8178
- **Mailing address:** 1024 KILLARNEY DR, DYER, IN 46311-1293

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01038347 | KS | Yes |

## Other

- **Enumeration date:** 01/05/2018
- **Last updated:** 03/18/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1003724508 | — | IN |